Eating disorders in a capitalist world: super woman or a super failure? podcast

Transcript

Eating disorders in a capitalist world: super woman or a super failure?

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Daniel Ridge (DR): Hello, and welcome to the Emerald Publishing Podcast Series. I'm your host Daniel Ridge, a Commissioning Editor at Emerald and I'm thrilled to bring you today's guest Dr Jelena Balabanić Mavrović. Today we dive into a pressing issue that affects at least 9% of the global population: eating disorders. Author Dr Balabanić Mavrović navigates this complex terrain in her new book, titled Eating Disorders in a Capitalist World: Super Woman or Super Failure. In this work, she uniquely blends her roles as sociologists and reality therapy counseling therapists to offer a nuanced understanding of eating disorders, informed not just by academic rigor, but also by deeply personal real life experiences. Her commitment extends beyond theory as she’s a co-founder of the Center for Eating Disorders BEA in Zagreb, Croatia, reflecting her dedication to making a tangible difference in the field. She has dedicated her life to therapeutic work with individuals struggling with conditions like anorexia, bulimia and binge eating disorder. In her book, Dr Balabanić Mavrović combines scientific analysis with personal narratives from in depth interviews to explore the societal forces shaping eating disorders. In today's episode, we'll unpack her research further. I began my conversation with Dr Balabanić Mavrović by asking her to elaborate on the challenges researchers face in understanding and addressing eating disorders in today's society.

Jelena Balabanić Mavrović (JBM): We can say that we know a lot about eating disorders, but they're still an enigma. All research are done today in bio psychosocial model, or paradigm that believes that eating disorder results of serious of commodity influences. So from genetic predisposition, psychological personality traits, maybe some traumas or experiences difficult experiences in growing up, or some specifics in family dynamics. But also, we have to remember that exposure to peer influence, maybe teasing and cultural influence that emphasize the idea of thinness or it was a perfect appearance for women, or for men, athletic or muscular body for men. So these are all segments influence and result. Their result is eating disorders. But what we know is a lot but also we have some unanswered questions. Like why mostly young women suffer from anorexia and bulimia? And also how similar and how different anorexia and bulimia in their etiology are? And maybe also to what extent genetic predisposition and cultural influence actually lead to eating disorders? And also, I think maybe the most important question is, what is the most effective treatment for different forms of eating disorders, because today, we know that average treatment lasts from four to seven, maybe even to 10 years. And we have a tiny percentage of people suffering from anorexia and 30 to 40% of people suffering from bulimia that remain chronically ill. So we have to also state that anorexia is the mental disorder will be to the highest mortality among adolescent girls. So it is very important that we search and find answers to these questions. Maybe just to add that, in last half century, there was a strong race in eating disorders. So we we have to think about why now, why in second half of 20th century, eating disorders are so present, and also that we have new forms like bulimia was recognized in 1979. And five or 10 years ago, we showed a definition for binge eating disorder is a special form of eating disorders. So diagnostic changes, and also may be for phenomenology of eating disorder changes throughout the years. And it is a challenge for a researcher to look into eating disorder.

DR: Yeah, there is a lot there that I'd like to unpack through a conversation. One thing that I'm curious about is how you mentioned historically how eating disorders were recognized at different periods of time. And I'm wondering how the perception of eating disorders has evolved over time, from, you know, our early medical interpretations to more recent sociological and feminist perspectives.

JBM: Yes, it is very, very interesting, because at the beginning, we can say that eating disorders, because of the strong physiological effects of anorexia, that is, we can say, the most popular or the most recognizable form of eating disorder. So it has a strong somatic picture. And so it was seen is, is organic disease at the beginning of 20th century, but then at the same time, because of the raise of cycle analysis. So at the beginning, we had some pretty bizarre theories that it was a subconscious fear of oral impregnation in in bases. And it was really strange. But then it after Second World War, Hilda proof American psychiatrist of German origin, she put foundation for today, understanding of eating disorder, she walked into it in a way that it was a developmental psychological disorder, that is mostly characteristic for young girls who strive for our autonomy, and search for the identity. And most of it is like a framework for today's understanding of eating disorders.

DR: Well, so you know, the relationship between eating disorders and cultural influence has been a subject of debate with researchers. And some of you more as a culture bound syndrome. And others view is where they emphasize the socio cultural factors like media pressure and body ideals. And especially, you know, we live in a society that is just inundated with social media and body images and these ideals. So I'm wondering, you know, how do these perspectives impact our approach to prevention and treatment, becoming conscious of it?

JBM: Well, as you can see, with eating disorder, nothing is simple. So everything is very complex. And this phenomena has many layers. So it one point we can say it's a strong influence of the media. And that was the main point of feminist perspective, that was very present in the last part of, of 20th century, that pointed out that this media objectification of female body, put great pressure on on young girls, who also saw themselves as not good enough, not perfect enough, not beautiful enough, is all those models in magazines, then, today, we can transfer this into influence from social media. That is maybe even worse, because young people are literally throughout the day, are with their cell phones, and on social media, looking at those perfect pictures that are filtered data changed. And although they know that it is not reality, but this subliminal influence is, is very, very strong. There was one research that showed that when women looked at the photographs of other women with models, and it was put so in words, these pictures are altered, they're not real. They were photoshopped or filtered, but the result was the same as when women watch the pictures that are without those warnings. So they felt shamed with lower self esteem, worse body image after only five minutes of looking at those photographs. So we can say that those messages that the true visual media That's a very, very strong and powerful. And also we have one another example on island Fiji.

DR: Yeah, that really struck me in your book, this example of Fiji.

JBM: So in 1985, English, American, I think, researcher named Becker went to Thailand and made the survey tested the girls. And they showed a very healthy relationship with their bodies, very good self-esteem. Because traditionally, Fiji society regards larger body bodies as very nice, it the sign of wealthy family of community that takes care about their member. But after that time, so in 1985, satellite television was introduced into the island. And three years after the same research was, again conducted there. And it was showed that the level of binge purge or bulimia symptoms were the same as in American high schools or whatever the same age group. So we see that only in three years of exposure to media to Western media, he had such a devastated results on the traditional society. But maybe when we look at it, we should go beyond just imitation so that girls looked at the very thin models or women on TV screen. But that was all the it was only a sign of some deeper messages that satellite television provided. So even girls from Fiji, explain that through that thin body, they wanted to have that social position of a very influential, successful woman that they saw on a television. So through that body image, they did not want to be just beautiful, a thin, they wanted that position in a society that those beautiful and perfect women had. So it is much more complex than just a superficial, it's the status. It's not just imitation. It's just symbolic communication, of lifestyle and of values.

DR: Yeah, well, you know, we've been talking about women and we often associate eating disorders with women. But what do we know about the prevalence and experiences of males with anorexia and bulimia? And how does gender influence the diagnosis and treatment of these disorders?

JBM: Yes, I think that in the future, we will have more men suffering from eating disorders. Maybe today, they suffer from double stigmatization, because we have mental disorder that is already stigmatized as such, but also because eating disorders are perceived by the public as feminine disorder. So these are two obstacles for men with eating disorders, to search for help for expert help. But we know that about 10% of people with anorexia are male were boys or men. And with bulimia, it's estimated about 30%. In binge eating disorder, we have just a little bit more female than male, but men are really well, representative, we can say that in binge eating disorder. But I would like to emphasize that maybe new forms of eating disorders, like orthorexia, that is very common in fitness industry, combined with what we call bigger a bigger Exia. It's muscle this for me, is maybe one form of eating disorder that is more characteristic for male male population. And that so it's like bodybuilder things, or fitness thing that men and saw themselves well, they see themselves as a weaker, weak or fragile, although they're really bold. can't be full of muscles, but it is like reverse anorexia. They just can't get big enough. Yeah, girls with anorexia can be enough teen because they always see themselves as a little bit like to fit or something is going on. And also people who have muscle dysmorphia see themselves as weak, not muscular enough. So maybe that is the way for for male eating disorders to be seen, and maybe to focus on the form of eating disorders in in the future, you know,

DR: I'm curious to know what treatment looks like, and also maybe the differences between the different types of bulimia anorexia that we've been talking about, really, what does treatment look like? And, you know, we've identified several things that may cause it, and how complex that is, but what does what does it take for someone to go and get help? And what does that help look like?

JBM: I think that first step or just recognizing that someone has a problem is the hardest for people with eating disorders, because in their head, it is always like, I have to do this by myself, do I want to get well because if I get well I will get fat. And that is the greatest fear that anyone with eating disorder has. So maybe in that state of mind, people somebody says I will rather die than get fat.

DR: Because they think help means that they will gain the weight. Yes.

JBM: Yes. And and for them also, there is a question that if anyone will understand me, no one understand what is this inner compulsion not to eat or eat and purge or just eat in betweening disorder, so that this is like something that is stronger than me, I cannot just decide not to purge, but okay, we have different sorts of of eating disorders, but in in basic level, they have many similarities, maybe we can say that this distorted image of the body is like the common ground of all forms of eating disorders. And then some intolerance of, of feelings of mood intolerance of we can say bed emotions, because it is felt as a tension in our tension like inner state that is hard to bear. And then people started search, some sort of relief in symptoms, eating disorder symptoms, like not eating because people with anorexia, when you feel hunger and you do not eat, then all the feelings are less present, because hunger covers all of it. Also, when people are binge, then they find some sort of relief in binging and purging. So, it is sort of emotional regulation. So we can say that it is one way of looking at eating disorders. And also when something is going on in person's life, that they cannot feel that they are in control of it. Something's going on in family, like transition years in schools, someone is moving to another city or something like this, some break in a relationship love relationship, then there are all triggers for a sense of helplessness and sales, the sense of losing one sense of identity person asks, Who am I am I worthy enough? What are my advantages? What Why am I in this world? How will I succeed in this world? And then if we feel incompetent, then relationship with food and body is maybe the last frontier that we can achieve that sense of self control?

DR: Yeah, you know, I mean, along with that you you do discuss in your book, how sexual trauma can be associated with eating disorders, and how that can lead you to dissatisfaction with the body and a distorted relationship with food having had sexual trauma. Can you elaborate on the ways in which trauma like that influences eating disorders? And how individuals cope with their traumatic experiences through the relationship with their bodies and with food?

JBM: Yes, yes. Well, we firstly, we have to say the, that the sexual trauma is not the cause of all eating disorders. But some people with eating disorders have experienced sexual trauma. And with them, it is very hard to have a good relationship with their body. Because especially we are now talking about female patients or girls and women. Because the curves, remind them of past events, and also carry potential for retraumatization. So in a way, they reject components, which are socially related to the female gender, like curvy female body sexuality. And what I found in my research that they reject very often the idea of reproduction, so motherhood, and marriage. So sexual trauma for these women is written in their bodies. And they can develop very serious ways of self harm, or out of destructive behavior. And also, they want to be, in a way invisible or thin, maybe go to the childlike body. And they maybe feel that if they look like a child, or like boy or Centrelink that they teach will protect them in future life, when when they will not be exposed to maybe future trauma, or sexual assaults. So maybe this is the point where we can say that when people talk about eating disorder very often they think that it's a way to, for girls to be beautiful, to be entertained, to look like models. But we have a very large group of people with eating disorders. For us eating disorder symptom just for opposite intentions. They want to get rid of their sexual attributes, they don't want to be beautiful, they want to be invisible. They want to get out of that sexual market or have that expectation, what adulthood or maturity brings.

DR: When thinking again, about treatment, because this is all so complex, and it's so individual, for why somebody would have these these relationships with food that are so complicated.

JBM: Yes, yes, in a treatment, it is very important to look for individual story. And to go to the roots of disordered eating habits and disordered body image. And we know that there are several therapies that are used CBT E, so it's cognitive behavioral therapy is very good, evidence based. And also psychodynamic therapy, and interpersonal therapy. And also family therapy is very good, especially for younger girls, with anorexia especially. And maybe here, it is very important to point out that family involvement, and psychoeducation of the whole family, especially parents, it's crucial, because it won't head they will understand more easily what is happening with their child. But also, for them, this is a chance to progress and to grow, and to become part of the change, not a part of the problem.

DR: While looking at the title of your book, or really the subtitle Superwoman, or super failure. I noticed that in your book, you you discuss two contrasting stereotypes, and that's the woman is the victim and the Super Woman. Can you discuss these stereotypes stereotypes and talk a little bit about what the interviewees said in your book about these ideas?

JBM: Yes, yes, it was very interesting for me that in our research, those two main stereotypes came out is a is a two dominant ways that female patient in eating disorders unit of psychiatry hospital, think about female role. So we have one is a woman is a victim, it is a traditional role. So this is a woman submissive to a man, she's directed to maintain the household caring for husband and children. So it is a person who is sort of vulnerable, emotional, we could say like weak and dependent. And everyone in a group that was interviewed was against that stereotype they rejected. And they distance themselves from that stereotype like, No, this is like a legacy from patriarchal society, from our grandmothers, or even mothers, but we don't want to take that role in society. And if that means to be a woman, we don't want to be a woman. So this gender role is not acceptable for us. But on the other hand, we have this super woman stereotype. This is like, emancipated woman in a capitalistic neoliberal economy. And she is like, winner in all fields. She she has a career, her husband, children, she is financial independence, she's very educated. And beside that the Super Woman is thin and beautiful. And she takes care of herself. She eats healthy and exercise regularly. So we can see that this is like unrealistic and either wise expectation, because no one can be that perfect. So this doesn't exist in real life. So towards that stereotype, women with eating disorder showed both admiration and rejection, because it was too much to achieve that sort of unhuman. Superwoman, ideal, and it frightened them in a way, so they prefer it over the traditional woman. But maybe it is like too much to be so perfect. So these two stereotypes created some sort of confusion in answering how to be a woman in today's society. So if we don't want to be this traditional victim, then we have to be the Superwoman. But that is so hard, that is impossible, we can never reach that that sort of superhuman being. And then solution is just to stop our development. And maybe in a way, eating disorder is a sort of waiting room for adulthood. Because while a girl is having eating disorder, she doesn't have to grow up. She is protected from all those demands of today. Female into today's society, from that we expect of today successful woman to be really like, like a super woman, she has to do it all and she has to win in all those fields. And maybe there's too much

DR: Well, kind of overlooking your book and all the work that you've done with your research with your, your work with interviewees. I really want to ask you what your hopes are for the book, and what sort of real world impact you would hope to have outside of academia.

JBM: My deepest wish is that this book reaches people with eating disorder. I would also, of course, be glad that academia understands also this perspective, that social impact of gender role, how it is combined with eating disorder and and that is very important perspective to understand how personal and social come together. But I think that in my private in deep in my heart, I wish that people with eating disorder. Well girls and women with eating disorder read this book, and they find inspiration to search in their own heart and soul and see how they resonate with this. insight, and maybe that this book serves as an inspiration to further therapeutic work. And that each, each reader finds her own answer to those hard questions. Maybe I would like this book offers an answer, that we don't have to be super women to be worthy, human beings that being sometimes being weak, and experienced some loss, or some and perfection, that is like a core of human experience. And that if we deny ourselves to be imperfect, I think that we deny ourselves the right to live. So this like soft, gentle approach that is filled with acceptance, and with the right to be different, to choose our own path in life, whatever that means, to each of us that, from my point of view, is the solution to be healthy and happy. And to improve our mental health?

DR: Well, you yourself have several different roles. You're an activist, a therapist or researcher in the field of eating disorders. So you definitely wear multiple hats. How did these roles intersect? And how have they influenced your approach to your work?

JBM: Yes, I see that these roles, well, these multiple roles have advantages. Because when I researched for this book, before, I had some knowledge and experience that came from many years of practice, in preventive and educational work with patients of eating disorders and their families, so I felt like an insider. And also, I think that interviewees also accepted me as one of them. Because very often in their interviews, they use the phrase us and then classifying people suffering from eating disorders like us, and they put me into it. So I was very, very flattered. And maybe I see myself as a bridge between eating disorder sufferers and the scientific community or even community in general. And maybe I feel double loyalty at one hand, to the academic community, which is interested in the result of the research and my book, but also on the other hand, too, eating disorder sufferers, their attitude, experience and feelings. I tried to translate that into scientific language.

DR: Great, thank you so much for taking the time to speak with me today. This has been really interesting.

JBM: Thank you.

DR: Thank you for listening to today's episode. On our website, you can find more information about Dr Jelena Balabanić Mavrović, as well as a transcript of our conversation. I'd like to thank you Jelena, and also Sian Heron from the studio This is Distorted or her help with this episode.